<div class="layuimini-container">
  <form id="app-form" class="layui-form layuimini-form">

    <div class="layui-form-item">
      <label class="layui-form-label">适用门店名称</label>
      <div class="layui-input-block">
        <input type="text" name="store_title" class="layui-input" lay-verify="required" placeholder="请输入门店名称" value="{$row.store_title}">
      </div>
    </div>
    <div class="layui-form-item">
      <label class="layui-form-label">门店电话</label>
      <div class="layui-input-block">
        <input type="text" name="store_mobile" class="layui-input" lay-verify="required" placeholder="请输入门店电话" value="{$row.store_mobile}">
      </div>
    </div>
    <div class="layui-form-item">
      <label class="layui-form-label">使用时间</label>
      <div class="layui-input-block">
        <input type="text" name="store_date" data-date="" data-date-type="date" data-date-range="-" class="layui-input" lay-verify="required" placeholder="请选择适用时间" value="{$row.store_date}">
      </div>
    </div>
    <div class="layui-form-item layui-form-text">
      <label class="layui-form-label">搜索结果</label>
      <div class="layui-input-block" id="demo1">

      </div>
    </div>
    <div class="layui-form-item layui-form-text">
      <label class="layui-form-label">腾讯位置坐标</label>
      <div class="layui-input-block">
        <input type="text" name="store_str" disabled id="store_str" class="layui-input" lay-verify="required" placeholder="请选择搜索结果" value="{$row.store_str}">
        <tip>搜索门店地址获取 腾讯位置坐标 “经纬度”</tip>
      </div>
    </div>
    <div class="layui-form-item">
      <label class="layui-form-label">门店地址</label>
      <div class="layui-input-block">
        <input type="text" name="store_name" class="layui-input" lay-verify="required" placeholder="请输入门店地址" value="{$row.store_name}">
      </div>
    </div>
    <div class="hr-line"></div>
    <div class="layui-form-item text-center">
      <button type="submit" class="layui-btn layui-btn-normal layui-btn-sm" lay-submit>确认</button>
      <button type="reset" class="layui-btn layui-btn-primary layui-btn-sm">重置</button>
    </div>

  </form>
</div>